From Protection to Prevention: Redefining Vaccines in the Context of Antimicrobial Resistance.

Antimicrobial resistance (AMR) poses a significant threat to global health, compromising the effectiveness of treatments and increasing medical risks. In this crisis, the importance of vaccines in reducing AMR is being increasingly acknowledged, although not thoroughly explored. This literature review asserts that vaccines can significantly lessen the occurrence of infections, thereby reducing the need for antibiotics and limiting the emergence of resistance.

Shifting the Scales: Tirzepatide's Breakthrough in Obesity Management.

Obesity is a complex and chronic condition that presents a significant global health challenge, resulting in a wide range of health problems, such as heart disease, stroke, and diabetes, therefore diminishing the overall well-being of numerous individuals. Conventional treatment options often prove inadequate, providing temporary relief and frequent weight regain. However, a promising medication called tirzepatide has emerged and been approved by the FDA as a groundbreaking solution for managing obesity.

Improving Antimicrobial Stewardship Program Using the Lean Six Sigma Methodology: A Descriptive Study from Mediclinic Welcare Hospital in Dubai, the UAE.

Background: Antimicrobial resistance (AMR) is one of the key challenges in healthcare, and effective antimicrobial stewardship programs (ASPs) can play a vital role to control it. The aim of the current study was to assess the impact of the Lean Six Sigma (LSS) methodology on a hospital-wide ASP.

Methods: This retrospective descriptive study was conducted at Mediclinic Welcare Hospital (MWEL), Dubai, the United Arab Emirates (UAE).

Human albumin solution utilization patterns prior and during COVID-19 pandemic in United Arab Emirates: Time to develop and implement national guidelines on prescription and utilization.

The human albumin solution (HAS) has limited but important indications in clinical practices. However, the inappropriate use of HAS can be costly. Thus, it is imperative to establish a practical protocol to use albumin products and rationalize its usage.

Cerebral autoregulation in infants during sevoflurane anesthesia for craniofacial surgery.

Background: Data on cerebral pressure-flow autoregulation in the youngest children are scarce. We studied the correlation between mean arterial pressure and cerebral tissue oxygen saturation (rSO ) by near-infrared spectroscopy (NIRS) in patients undergoing nose, lip, and palate surgery.

Aim: We tested the hypothesis that cerebral pressure-flow autoregulation is impaired in children less than 1 year undergoing surgery and general anesthesia with sevoflurane under controlled mechanical ventilation.

Agreement between frontal and occipital regional cerebral oxygen saturation in infants during surgery and general anesthesia an observational study.

Background: Advances in perioperative pediatric care have resulted in an increased number of procedures requiring anesthesia. During anesthesia and surgery, the patient is subjected to factors that affect the circulatory homeostasis, which can influence oxygenation of the brain. Near-infrared spectroscopy (NIRS) is an easy applicable noninvasive method for monitoring of regional tissue oxygenation (rScO₂%).

Determinants of mortality after hip fracture surgery in Sweden: a registry-based retrospective cohort study.

Surgery for hip fractures is associated with high mortality and morbidity. The causes of poor outcome are not fully understood and may be related to other factors than the surgery itself. The relative contributions of patient, surgical, anaesthetic and structural factors have seldom been studied together.

Perioperative COX-2 inhibitors may increase the risk of post-operative acute kidney injury.

Background: In enhanced recovery protocols (ERP), a restrictive fluid regimen is proposed. Patients who undergo major surgery have an increased risk of post-operative acute kidney injury (AKI). This combination may pose difficulties when ERP is used for patients undergoing major surgery.

Erratum: Music structure determines heart rate variability of singers.

[This corrects the article on p. 334 in vol. 4, PMID: 23847555.

Music structure determines heart rate variability of singers.

Choir singing is known to promote wellbeing. One reason for this may be that singing demands a slower than normal respiration, which may in turn affect heart activity. Coupling of heart rate variability (HRV) to respiration is called Respiratory sinus arrhythmia (RSA).

Fluid therapy in acute myocardial infarction: evaluation of predictors of volume responsiveness.

Background: Static vascular filling pressures suffer from poor predictive power in identifying the volume-responsive heart. The use of dynamic arterial pressure variables, including pulse pressure variation (PPV) has instead been suggested to guide volume therapy. The aim of the present study was to evaluate the performance of several clinically applicable haemodynamic parameters to predict volume responsiveness in a pig closed chest model of acute left ventricular myocardial infarction.

Endovascular management of acute bleeding arterioenteric fistulas.

The objective of this study was to review the outcome of endovascular transcatheter repair of emergent arterioenteric fistulas. Cases of abdominal arterioenteric fistulas (defined as a fistula between a major artery and the small intestine or colon, thus not the esophagus or stomach), diagnosed over the 3-year period between December 2002 and December 2005 at our institution, were retrospectively reviewed. Five patients with severe enteric bleeding underwent angiography and endovascular repair.

Intestinal nitric oxide output during reduced mucosal blood flow in healthy volunteers.

Objective: Nitric oxide regulates epithelial permeability and other properties of the intestinal mucosal barrier. It previously has been shown in animals that intestinal mucosal nitric oxide production is impaired during gut hypoperfusion. The study was performed to confirm the presence of intestinal mucosal nitric oxide production in humans and to investigate the effect of gut hypoperfusion due to moderate arterial hypotension on intestinal nitric oxide concentrations.

Jejunal luminal nitric oxide during severe hypovolemia and sepsis in anesthetized pigs.

Objective: Lowered gut blood perfusion and the associated intestinal mucosal barrier dysfunction is considered important in the pathophysiology leading to critical illness. Intestinal mucosal nitric oxide formation has been attributed a key role in the regulation of epithelial permeability and other properties of the intestinal mucosal barrier. This study was performed to delineate intestinal mucosal NO formation during hypovolemia or sepsis, both of which are associated with intestinal hypoperfusion.

Jejunal mucosal nitric oxide production and substrate dependency during acute mesenteric hypoperfusion in pigs.

Objective: Jejunal nitric oxide (NO) formation is impaired during mucosal hypoperfusion. This study was undertaken to investigate whether this phenomenon could result from a restricted mucosal availability of NO-synthase substrates, ie, oxygen and/or L-arginine.

Design: Controlled study using laboratory animals.

Tonometric assessment of jejunal mucosal nitric oxide formation in anaesthetized pigs.

Nitric oxide (NO) in the gut has attracted increasing interest as a regulatory factor for a wide variety of intestinal functions. This study was performed to evaluate some methodological aspects and jejunal sources for NO synthesis. Bench side evaluations and an animal model using chloralose-anaesthetized pigs were used.

Differentiation of the peptidergic vasoregulatory response to standardized splanchnic hypoperfusion by acute hypovolaemia or sepsis in anaesthetized pigs.

This study was performed to integratively investigate the vasoregulatory response during standardized splanchnic hypoperfusion in pigs. Splanchnic perfusion was reduced to 50% of baseline by: haemorrhage by 20 and 40% of the estimated total blood volume; femoral venous infusion of live E. coli to establish sepsis of systemic origin; portal venous infusion of live E.

Detecting gastrointestinal hypoperfusion during cardiac tamponade in pigs: a role for nitric oxide tonometry?

Objective: To evaluate different techniques and regional approaches for detecting critical reductions in gastrointestinal (GI) perfusion.

Design: Laboratory, animal, controlled study.

Setting: University animal research laboratory.

Continuous measurement of gastric nitric oxide production.

With the use of a double-lumen catheter, nitric oxide (NO) was dialyzed across a Gore-Tex membrane into a gas phase and subsequently analyzed on-line by chemiluminescence. This new technique for the continuous measurement of NO was evaluated bench-side and applied in the human stomach in vivo to measure the nonenzymatic formation of NO generated from nitrite in an acidic milieu. A linear relation (r2 = 0.

Accumulation of an endogenous inhibitor of nitric oxide synthase during graded hemorrhagic shock.

Asymmetric dimethylarginine (ADMA) represents an endogenous inhibitor of nitric oxide (NO) production. The production of ADMA has been shown to increase during cellular stress, e.g.